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Month: November 2018

When the Heart Fails

In the United States, it is estimated that 6.5 million people suffer from heart failure, with 50% having a survival rate of less than five years. Heart failure accounts for the most hospital readmissions, with up to 50% of patients readmitted within 3-6 months (Baptiste, Mark, Groff-Paris, & Taylor, 2014).

Heart failure (HF) is a condition in which the heart is unable to pump enough blood to meet the demands of the body. When this occurs, the body does not get enough oxygen. There are different types of HF – systolic and diastolic. Heart failure can also be isolated to different areas of the heart, creating right-sided, left-sided, or biventricular heart failure. The signs and symptoms of HF include shortness of breath, fatigue, weakness, edema, increased heart rate, pedal edema, and abnormal lung sounds (Inamdar, & Inamdar, 2016).

Systolic HF

-The heart is unable to pump with enough force to circulate blood throughout the body.

Smaller & weaker muscles = less force

Diastolic HF

-The heart does not fill with enough blood to circulate throughout the body.

Bigger muscles = less filling

Left-Sided HF

-The left side of the body pumps oxygenated blood to the body. In left-sided failure, the left side of the heart is not able to pump oxygen-rich blood throughout the body. This leads to a backup of blood into the lungs, leading to “congestion”, and symptoms such as shortness of breath or wheezing.

Right-Sided HF

-The right side of the heart pumps blood to the lungs for oxygenation. In right-sided failure, the right side of the heart loses its ability or the ability to pump blood is decreased. This leads to a backup of blood into the veins of the body, causing symptoms such as edema.

This video from Khan Academy illustrates heart failure – systolic, diastolic, right/left-sided, as well as biventricular. The drawings clearly show the impaired function of the heart in the presence of HF.

Let’s take a look at the causes of heart failure, more signs and symptoms, and how it’s diagnosed.

So What Now?

Management of heart failure

Once diagnosed, treatment of HF focuses on reducing symptoms and mortality. This can be accomplished with certain lifestyle modifications, such as increasing exercise, restricting salt, limiting alcohol intake, weight loss, and fluid restriction. Certain medications, such as ACE inhibitors, beta blockers, ARBs, diuretics, digoxin, nitrates, as well as anticoagulant therapy are used in the treatment of HF. In some cases, a device may also be implanted as part of treating HF, such as an implantable cardioverter defibrillator (Krum, & Driscoll, 2013).

The second part of this video discusses interventions. Although it is from a nursing perspective, these interventions are important and can be applied by anyone in the treatment of heart failure. Another piece of information that this video addresses is pharmacological treatment for heart failure.

The use of e-cigarettes is one of the newest and most popular trends today. Unlike traditional cigarettes, e-cigs are battery-operated and produce a chemical filled aerosol by a heating of the liquid. E—cigarettes are commonly known as “e-cigs,” “mods” or “vape pens.” E-cigarettes resemble regular cigarettes, pens, or USB sticks.

This video is a perfect example of how e-cigarettes are portrayed in the media. Below are some common myths that are “debunked” after thorough research.

Myth: E-cigarettes are a safe alternative to traditional cigarettes

Fact: E-cigs contain fewer toxins, but they are not harmless. E-cigs still contain nicotine, which is highly addictive and can negatively affect the human body. These effects include elevated heart rate and blood pressure, airway inflammation, impaired immunological response and decreased lung function. Aside from nicotine, e-cigarettes also contain harmful toxins such as lead and cancer-causing agents. Consumers are misled to believe that e-cigarettes are a healthier alternative to traditional cigarettes.

Myth: E-cigarettes are a proven method for smoking cessation

Fact: There is little evidence that e-cigarettes lead to cessation. In fact, the nicotine in e-cigs may perpetuate nicotine addiction, making it harder to quit for some consumers. Many users find e-cigs to be less satisfying than traditional cigarettes, leading to dual usage, increased and constant vaping.

Myth: E-cigarettes are used exclusively by people trying to quit smoking

Fact:“Vaping” is becoming increasing popular with adolescents, including those who had never smoked cigarettes. Studies have shown that the majority of young people begin smoking traditional cigarettes only after vaping.

Yes, e-cigs are less harmful than traditional cigarettes. However, there is no evidence that they are “safe.” Cigarette smoking has been the leading cause of preventable deaths in the US. Anti-smoking campaigns have reduced the number of traditional cigarette smokers. In the future, e-cigarettes should be implemented into these campaigns so that consumers are not falsely lead to believe that they are safe by the media. Consumers should do their own research on the topic before deciding to begin smoking.

References

E-Cigarettes: What You Should Know. (2015). Consumer Reports on Health, 27(12), 9. Retrieved from http://library.neit.edu:2048/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=110405911&site=ehost-live

Provides “deep touch pressure” which has a calming and organizing effect on students who have trouble focusing in class

Weighted vests are often recommended by an Occupational Therapist to help a child successfully participate in school related tasks

Increased focus/attention

Increased time spent on a school task

Decreased anxiety associated with ADHD

Promotes calmness

Promotes organization

Within the following media clips and evidence-based articles is factual and false information regarding the use and effects of weighted vests on school aged children. The evidence based articles directly following the videos either prove the media to be providing true or false information.

in this media clip, Nancy VandenBerg (Occupational Therapist) discovers how weighted vests improve attention to task and provide a calming effect on the students in the school district that she works in.

A student reported: “It helps me concentrate a little harder.”

“Effects of Weighted Vests on Attention, Impulse Control, and On-Task Behavior in Children With Attention Deficit Hyperactivity Disorder” (Evidence-based article)

According to this article (place name of article above) this media source provides accurate information.

This scholarly article, written by two Occupational Therapists, analyzed the question “do weighted vests improve attention to task in school aged children?”

The study analyzed 110 school aged children diagnosed with ADHD and the effects of weighted vests on their attention to task.

The students only had one diagnosis (ADHD) and were not on medication during the duration of the study.

Findings of the study: “although wearing a weighted vest is not a cure all strategy, our findings support the use of weighted vests to remedy attentional and on task behavioral problems of children diagnosed with ADHD.”

In this media clip, a student and parent report their results of using a weighted blanket to improve attention to task.

A weighted blanket is essentially the same thing as a weighted vest and is made for the same purposes-to improve attention to task in children diagnosed with ADHD.

The student reports that the weighted blanket has a calming effect and helps him to sit still and focus better in class.

The mother reports that his grades have improved since he began using the weighted blanket.

The classroom teacher reports that she is pleased with his school performance since using the weighted blanket.

“The effect of the wearing of weighted vests on the sensory behavior of learners diagnosed with attention deficit hyperactivity disorder within a school context” (Evidence-based article)

This study was conducted by three Occupational Therapists.

This study confirms that the above video is in fact true information.

This article aimed to study the effects of weighted vests (much like weighted blankets).

It studies 30 children aged 6-9 who were diagnosed with ADHD and reported to have poor in seat behavior and task completion by their classroom teacher.

The conclusion of this study suggests that the intervention of utilizing weighted vests improves classroom behavior and performance of students diagnosed with ADHD.

In this media clip, the focus is the concern of the parents regarding the weighted vest being used on their 4-year old child without their consent.

My focus of the video is that the weighted vest was deemed not useful after being used for ONLY one minute.

“The Use of a Weighted Vest To Increase On-Task Behavior in Children With Attention Difficulties” (Evidence-based article)

In this peer reviewed article, written by Nancy VandenBerg (Occupational Therapist), she studies the use of weighted vests on children diagnosed with ADHD and the appropriate time that students should be wearing the vest for the vest to be effective.

The weighted vest is used for 15 minutes to have effects on attention to task in school aged children.

The study was conducted on 4 students.

The children’s attention to task was observed for 15 minutes with the weighted vest on and for 15 minutes with the weighted vest off.

The results of the study: “on-task behavior increased by 18% to 25% in all 4 students when wearing the weighted vest for 15-minute intervals.”

After exploring facts and fiction through various evidence-based articles, I have been able to validate that the first two news videos about weighted vests/weighted blankets provide accurate information regarding the correct use and results of weighted vests/blankets in school aged children. Video three has been debunked and proven to have been used incorrectly, resulting in poor results on the student’s attention to task. How is a weighted vest used?

Wear on top of clothing

The weight of the vest should be 5%-10% of your child’s total body weight (your child’s body weight multiplied by .05 or .10)

This article examines whether adhering to the Dietary Approaches to Stop Hypertension (DASH) diet can reduce the risk of ischemic stroke.

The DASH diet consists of vegetables, fruits, and low-fat dairy products and has reduced amounts of saturated fat, total fat, and chole.

This diet has been known to reduce hypertension which is one of the risk factors for having a stroke.

The results of the study was conducted on a cohort of 74,404 Swedish men and women between the ages of 45-83 years old with no history of stroke.

The results showed that those in the highest quartile of the modified DASH diet had a 14% reduced risk of ischemic stroke compared to those in the lowest quartile. Also, high adherence to the diet was also associated with a lower risk of intracerebral hemorrhage, it however had no association with subarachnoid hemorrhage.

This concludes that a diet like the DASH which is recommended by some health organizations can reduce the risk on ischemic stroke.

Diet for Stroke Prevention

This article is about the importance of diet and lifestyle in stroke prevention. According to Spence, “poor lifestyle choices account for more than half of strokes.”he writes that people who don’t smoke, have moderate alcohol intake, a body mass less than 25%, exercise 30 minutes daily, and eat healthy have an 80% reduction of stroke compared to those that who do none of these. Some of the things Spence addresses in this article include harmful dietary trends, diets associated with stroke prevention, certain foods related to stroke lastly, he makes recommendations for those at risk for stroke.

This article also concluded that coffee contrary to popular belief is beneficial and not harmful in stroke prevention.This is because according to Spence both coffee and tea reduce cardiovascular disease and diabetes which are risk factors of stroke.He also states that green tea lowers blood pressure, reduces LDL cholesterol, and improves endothelial function.

Stroke and nutrition: A review of studies

This article analyzes previous studies done that showed a relationship between diet and stroke prevention.

They also list and explain which foods and drinks effect the risk of stroke.Some of these foods included meats, fruits and vegetables, tea, and soft drinks.

The results of this study showed that adhering to a healthier diet such as the Mediterranean or DASH can reduce the risk of stroke.

This video supports the claims made in the above articles on stoke prevention through a balanced diet. It provides examples of foods that have been scientifically proven to help reduce Stroke risk.

In this video Dr. Lee Schwamm, Chief of MGH Stroke Service, explains the importance of exercise in stroke prevention and how to over come barriers when it comes to exercising by sharing his own exercise habits and routine.

Other Media Findings That Contradict This Information

Exercise Does Not Prevent Blocked Arteries, Study Finds

This article explains the findings of a long term study conducted by researchers from the University of Illinois at Chicago (UIC) and the Kaiser Permanente in Oakland, CA.

The study included over 3,000 participants, this included black and white men and women between 18 and 30.

The participants were followed-up for 25 years, until 2011. They underwent eight examinations over this period and filled in questionnaires reporting their levels of physical activity.

To their surprise while researchers expected to find that those with higher physic al activity levers would have a reduces risk off CAD the fin dings were contradictory to this.

The results of the study concluded that white men who exercise three times above the U.S. national guidelines for working out (150 minutes per week) are 86% more likely than black men, and those who exercise less, to develop a buildup of plaque in their hearts by the time they’re middle aged.

This study goes against the information provided in the previous pieces of media and in most peoples belief that exercise is good and helps keep people healthy and prevention disease. This article has many limitations and I don’t believe this in formation is reliable. It has been published in credible sources such are the new York daily news however, requires further investigation. The study was only shows the correlation between white man and black black men’s likely hood go getting CAC. This means further research should be done to clarify the role of race in the risks for CAC in people with high phial activity levels. Maintaining a proper diet and exercising regularly has been proven on many occasions to prevent disease including those that increase risk of stoke such as diabetes, CAD, obesity, and hypertension. There is more liable information that proves this fact than that which doesn’t.

Lyrica is a medication used to treat neuropathic pain from diabetes or herpes zoster (shingles), seizures, and Fibromyalgia.

This commercial talks about Lyrica helping with widespread pain so that people can get out more and improve on their daily functioning. As all prescription drug commercials do, this one talks about all the side effects quickly before ending the commercial.

A list of side effects includes dizziness, feeling tired or drowsy, constipation, diarrhea, nausea, headaches, increased weight, unsteadiness or reduce co-ordination, shaking or tremors, dry mouth, and blurred or double vision. These side effects are the more common and mild ones. Side effects that are more life threatening and less common include mental health changes, such as depression and suicidal thoughts, swelling of hands, ankles or feet, enlargement of breasts, unexplained muscle pain, or passing little to no urine.

This commercial points out some of the side effects, but not all of them, which further shows how important it is to discuss medications in detail with the provider prescribing them before you start taking them. What this commercial also does not point out is that Lyrica is not effective in people with post-traumatic neuropathic pain which means nerve pain caused by a traumatic injury such as a car accident (Lyric flops in pain study, 2016).

This is another Lyrica commercial that shows Lyrica for a different use. While the previous commercial talked about the drug being used for generalized pain and weakness, this commercial shows Lyrica being used specifically for diabetic neuropathy, which is nerve pain in the extremities caused from diabetes. This commercial gives a little more information about the drug because it lets us know that the drug is meant to have an affect on the nervous system of the body.

This commercial has the same exact information on the drug as the first commercial had, including some side effects while leaving others out.

This video on Fibromyalgia is most interesting. It discusses what the drug Lyrica does to the body and why it helps with pain. The neurologist in the video talks about Lyrica being originally developed as a seizure medication. Collins (2015) confirms that Lyrica was indeed created as an anti-epileptic medication and goes on to explain that the pain management was discovered after more studies were done.

This video talks about Lyrica’s effects on the body and talks about why it is a dangerous drug to use too often and how it does not fix the underlying reason for the pain. What Lyrica is meant to do is reduce excess electrical signals being sent out by the brain (Lyrica: 12 Things you need to know, n.d.). It is not stopping the pain, but stopping the brain from sending as many signals out for the pain. The doctor in the video also talks about Lyrica blocking the formation of new brain synapses. I am unable to find information that confirms or denies this statement, but the doctor in the video is getting the information from a study that he found.

All pharmaceutical drugs created have their benefits and side effects. Sometimes we take the word of the doctor when they prescribe one of these drugs to us. It is important that we are gathering as much information as we can about a medication before we put it into our body. Learn what you can and then decide; are the risks of the medication worth the benefits?

Healthy or Unhealthy for the Heart? Meat the Truth

We can all agree that good nutrition is important to live a healthy life. When we think about fruits and vegetables, we never question whether they are healthy or not. Some may have subjective thoughts about their flavor and uses, but I personally have never questioned their nutritional value to our health.

On the other hand, when we talk about MEAT…thoughts scatter and we get mixed emotions about the reality of the health concerns associated with it. Some media outlets have portrayed meat to cause HEART DISEASE, while others inform us that meat is important to consume for optimum health.

So the big question….

Does eating meat increase the risk of heart disease??

NO

According to researchers in the article A Contemporary Review of the Relationship between Red Meat Consumption and Cardiovascular Risk, consuming red meat is putting people at risk of heart disease because it has been related to high saturated fats and cholesterol content. Even after nutritionist and doctors recommended a diet with lean meat, it was still found to have high amounts of saturated fats that were still putting people at risk (Bronzato, 2017).

The most significant factors in meat that determine heart disease are:

sodium levels

specific fats

additives used to preserve the meat

Why Sodium? Our bodies require sodium for our nerves and muscles to function properly by controlling blood pressure and maintaining a balance in our bodily fluids, but too much of it increases blood pressure, which increases the chances of heart disease. Aside from meat, other foods that include high sodium levels are:

Why Fats? Fats are also essential to our diets, because they provide the body with energy, help make hormones and also help the body absorb certain vitamin which allow our bodies to function at their highest. However, there are different fats and it is important to understand what they are to make better dietary choices and avoid getting heart disease.

*** Saturated fats: these types of fats raise something that is called low-density protein (LDL). This is the type of cholesterol you want to avoid, because it is the high one that may put a person at risk of heart disease. Saturated fats are mainly found in meat, dairy products, fried food and baked goods.

*** Trans fat: this is the type of fat that we consume when cooking with oils. These fats are what give food a better tasting quality and preserve the shelf live of cooked food. Unfortunately, just because it makes the food taste good doesn’t mean it is good for our bodies. Trans fat also increases out low-density cholesterol (LDL), which increases the risk of heart disease. This type of fat is also found in meat, but it is mainly found in baked goods, fried food and snacks.

These two types of fats are mentioned, because they are the most commonly consumed by people and are what set the action of an increased heart rate, leading to heart disease if not managed.

The Unprocessed Red and Processed Meats and Risk of Coronary Artery Disease and Type Diabetes article, states that regardless of this information, studies found that high consumption of sodium, fats and processed food can lead to heart disease, but research has also determined that red meat itself in a diet does not increase the risk of the disease– a combination of unhealthy consumptions do. People should be aware of the overall effect food can play on their health and should reduce the amount of processed food to maintain good health.

Although studies on this research reported that the consumption of meat can play a part in developing heart disease, researchers also debunked the myth that eating meat alone cannot cause heart disease. A combination of a persons dietary choices and level of activity is what determines overall health and meat just happens to be the main factor involved (Micha, 2012).

Why is Meat is Unhealthy?

As we continue searching for the truth about meat, videos like the one above strictly focus on what meat itself can do to a persons health, which is what misleads people into thinking that’s the only problem. This video disregarded all other factors of a persons lifestyle that may be contributing to the disease development and focused only on educating the public on the components that can make meat unhealthy.

According to the article Health Risks Associated with Meat Consumption, evidence was found in the connection between meat consumption and life style factors that contributed to a person developing and dying from heart disease (Richi, 2015).

Although it is true that meat is a great source of nutrients, proteins, vitamin A, Bs, iron and zinc, researchers also claims that not consuming meat can deprive us from these essentials and create other health risks. Moderation in meat consumption along with a diet that involves fruits and vegetables is what researchers recommend to live a healthy life.

Is Meat Good or Bad for you?

This Video is interesting, because it points out important factors that are not biased, such as:

Overall diet should be taken into consideration when determining health patterns (sugar and redefined carb intake) and highly processed fat.

Good research on diet is hard to do, because researchers are not studying the right people. Instead studies are made on people who drink/smoke, overeat and were not very active.

People who ate less meat on studies were healthier, because people who were more health conscious lowered their meat consumption due to the skepticism of meat and took better care of themselves.

This video does a good job in expanding our thoughts as to why people are more prone to develop heart disease based on their overall lifestyle choices rather than just focusing on their dietary choices. It provides a different perspective, but ultimately adds to the confusion of whether or not eating meat causes heart disease.

Overall, it is safe to say that research has determined two facts– Meat consumption can play a key role in the development of heart disease, but the though that meat alone is the cause of disease is not true. The studies have proved that a persons poor choice in food is what will ultimately lead a person to illness. What we choose to consume will consume us.

This article explains the role of non- pharmacologic ( natural and drug free medicine) therapies and pharmacologic ( prescription and over- the – counter medication) therapies in the management of osteoarthritis.

Natural and drug free medicine include:

weight reduction through diet and exercise

Correction of malalignment of the joints of the joints with used of braces

Prescription and over – the – counter medications include:

Medications that can be taken by mouth.

Medications in the form of topical ( can be applied on the surface of the joints: cream, gels, lotions, or ointments)

Injections

Surgery: minor or major surgery

This article supports this media video; both the media video and this source report similar treatment methods for the management of osteoarthritis. Therefore, I find this information on the media video to be credible.

Osteoarthritis is the fastest growing cause of disability. Individuals with this condition may take some control of their own condition by making a change in their diet which could potentially ease the symptoms and reduce the progression of the disease.

These are some of the recommendations:

Lose weight, if overweight, through exercise.

Reduce high cholesterol food.

Increase omega- 3 fatty acids; eat oily fish times a week.

Eat rich vitamin- D food- milk

Increase vitamin-K intake by eating green leafy vegetables.

This article supports the video on the proper diet for individuals with osteoarthritis; however, the author did not make any suggestions on the type of diet that should be avoided. I would recommend this media video as credible.

Media Video

This media video claims there is a cure for osteoarthritis. The treatment is to stop eating dairy products such as milk and cheese.

How many times have you had to turn your car around because you forgot your wallet. Or how many times have you had to remind your mother that her doctor’s appointment is Tuesday, not Thursday. As we get older so do our brains. It is normal to become more forgetful as we age, but when does slight confusion become something more dangerous? With humans living longer and longer, diseases such as Alzheimer’s are becoming more common. According to the Alzheimer’s Association, there are over 5.7 million Americans living with this disease. Although Alzheimer’s disease is the most common cause of dementia other factors such as heart disease and strokes can cause this as well.

Dementia is not a disease in itself. Instead, it is a cluster of symptoms. These symptoms vary from person to person however, the defining symptom is a gradual decline of brain function. This may begin with some increased confusion, your grandmother may forget where she left her recipe book even if it has never been moved. A year later you may realize that grandma has been eating expired food unknowingly. Eventually your grandmother will need help performing basic tasks such as brushing teeth, as her mind has forgotten how to. Although this memory loss is the most common and prevalent symptom, many sufferers also have personality changes that can cause a complete change of character. These changes can cause a nun to curse like a sailor, or a sailor to become a quiet, docile man. Behavioral symptoms can also change the normal behavior from a person with dementia. These symptoms range from hallucinations (sensing things that are not there), delusions (believing things that are not true), depression, anxiety, and agitation.

Dementia is more serious than your typical old-age forgetfulness and requires immediate attention. Dementia is often under-represented in the media and the image presented is typically underplayed. Many Hollywood movies that feature older adults with dementia, show a pleasantly confused woman who is brought back with stories from the past. A key example of this is the much loved film, “The Notebook.” In this film, a love story between a young Ryan Gosling and Rachel Mcadams unfolds. The ending of this movie is so touching because it shows the much older husband reading their story to the wife with dementia. Upon the end of the story the wife realizes that he is her husband and they have one final night together.

In reality however, those with dementia are unable to simply ‘snap’ out of their confusion. It is possible for these people to have moments of clarity, but these are far and few inbetween. Expecting that by reminding them of past memories will lead to curing or even pausing their confusion will lead to a lot of heartbreak.

Although The Notebook is one of the most popular movies with dementia as a theme, Still Alice is 2015 movie that shows the struggles of living with early-onset dementia. This movie accurately shows the physical and emotional toll that this disease can cause on a person. This clip is an accurate demonstration of what living with dementia is like.

Alice is shown talking to her husband. Initially we notice that she confuses herself and her daughter as her mother and sister. This is very common among many of those with dementia as they may think they are much younger than they are because their long term memory is more intact then their short term. The major event in this clip however is Alice getting lost in her home. This shows the extent to which memory loss occurs. Alice becomes so anxious over not being able to find the bathroom in her own home that she eventually messes herself. This heartbreaking scenario is life for many with dementia.

Although there is no cure for dementia, there are medications available that can help slow the progression of the disease. Early detection is crucial in order to help your loved ones. The biggest sign to look out for is memory loss that impacts their daily life. If your grandmother forgets your birthday, it is probably age-related confusion. However, if your grandmother wishes you a “Happy fifth birthday!” there is a chance it could be dementia related.

This video shows an accurate depiction of an early sign of Alzheimer’s. The mother is fixated on the purple scarf and can not sleep because she does not remember where it came from. Episodes like this become increasingly more common and more dangerous and the dementia progresses.

If someone you know is showing the warning signs of dementia, please urge them to get tested by a trained doctor. Early detection and treatment can lead to extra years of memory and health. If you need more resources please visit The Alzheimer’s Association at: https://www.alz.org/